Osteoporosis is a systemic skeletal disorder characterized by reduced bone strength and increased fracture risk, posing a major public health challenge. Hip and vertebral fractures, which predominantly affect older postmenopausal women, lead to significant disability and reduced quality of life. Accelerated bone loss begins during the menopausal transition, and early fractures (eg, wrist) can signal underlying skeletal fragility. Although effective screening tools and evidence-based lifestyle and pharmacologic interventions can prevent fractures, osteoporosis remains underdiagnosed and undertreated. Women's health clinicians play a critical role in integrating bone health assessment, prevention, and management into routine care for perimenopausal and postmenopausal women.
During the menopausal transition and into early menopause, women gain body fat, particularly centrally, and lose lean mass. There is a worsening of cardiometabolic risk factors including insulin resistance, dyslipidemia, and vascular function. Combined diet and exercise interventions, particularly when employed during the menopausal transition, show evidence for improvement in weight, body composition, and metabolic risk factors. Although there are limited data on the effects of first-generation and second-generation antiobesity medications and bariatric surgery, glucagon-like peptide 1 receptor agonists are promising agents to prevent and mitigate adverse changes in body composition and cardiometabolic risk.
Millions of women worldwide are diagnosed with cancer annually. Although most of these cancers do not directly impact reproductive organs, the cancer therapies used treat these tumors, namely surgery, radiation, chemotherapy, immunotherapies and hormonal agents, can drastically alter women's lives forever. The direct effects of cancer treatment on reproductive organs may alter fertility and induce temporary or permanent menopause. The psychological and physiologic impact of menopause on survivors is enormous. The loss of estrogen impacts cardiovascular, musculoskeletal, and neurologic health, quality of life, and long-term well-being.
